National MediclaimPolicy
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National Mediclaim Policy

National Insurance Mediclaim Policy is a traditional health insurance plan that provides comprehensive coverage to the policyholders. This plan was launched by the National Insurance Company to offer financial comfort to the insured at the time of a medical emergency. The Policy provides for Pre Hospitalisation (45 days) and Post Hospitalisation (60 days) expenses, 140+ Day Care procedures, organ donor's medical expenses, ambulance charges, Morbid Obesity treatment, correction of Refractive Error and provides for reinstatement of Basic Sum Insured (above SI of 6L), if applicable as per terms.

National Arogya Mediclaim Plus Policy Specification

Child Entry Age

3 months

Adult Entry Age

18 to 65 years

Plan Type

Individual/Family Floater

Policy Term

1 Year

Initial Waiting Period

30 Days

Sum Insured

1 L | 2 L | 3 L | 4 L | 5 L | 7 L | 10 L

*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.

Choose your National Mediclaim Policy

With wide coverage options, National Mediclaim Plus Policy lets you customize your health insurance plan as per your needs and requirements:

In-patient & Out-patient coverage

Room Rent

Up to 1% of SI

ICU Charges

Up to 2% of SI

Pre-Hospitalization

Covered up to 45 days

Post-Hospitalization

Covered up to 60 days

Domiciliary Hospitalization

Not Covered

Daycare Treatment

140+ procedures

OPD Charges

Not Covered

Coverage Terms

COVID-19 Treatment

Not Covered

Cataract

Not Covered

No Claim Bonus

Available up to 50% of SI

Automatic Restoration

Not Available

Daily Hospital Cash

Not available

Organ Donor

Covered

Maternity Cover

Not Covered

New Born Baby Cover

Not available

Alternative Treatments

AYUSH Treatment

Covered up to SI

IVF Treatment

Not Available

Modern Treatment

Up to 25% of SI

Emergency Coverage

Ambulance

Covered up to 2k

Air Ambulance

Not Available

Compassionate Travel

Not Available

Global Coverage

Not Available

Wellness Programmes

E-Consultation

Not Available

Health Check-Up

Every 4 claim free years

Second Medical Opinion

Not Available

Vaccination

Not Available

Limitations

Co-payment

Up to 20% Available

Sub-limits

Not Available

What is Room Rent?

The room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.

Common room categories covered under room rent are:

  • Private Single AC Room
  • Twin Sharing
  • General Ward

Coverage status under National Mediclaim Policy?

Under National Mediclaim Policy, the room rent is covered by up to 1% of the SI subject to a maximum of Rs. 10,000/- per day.

What are ICU Charges?

It is a special department in the hospitals where patients with serious medical conditions are treated.

Coverage status under National Mediclaim Policy?

Under this plan, ICU charges coverage is available up to 2% of the SI.

Under National Mediclaim Policy, the room rent is covered up to INR 20,000 per day

What is Pre Hospitalization?

Medical expenses incurred before the hospitalization of the policyholder.

Coverage status under National Mediclaim Policy?

This plan covers medical expenses incurred during pre-hospitalization for up to 45 days.

What is Post Hospitalization?

Medical expenses incurred after the discharge of the policyholder from the hospital.

Coverage status under National Mediclaim Policy?

This plan covers medical expenses incurred during post-hospitalization for up to 60 days.

What is Domiciliary Hospitalization?

Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.

Coverage status under National Mediclaim Policy?

Under National Mediclaim Policy, domiciliary hospitalizations are not covered.

What is Daycare Treatment?

Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.

Coverage status under National Mediclaim Policy?

This plan covers expenses of 140+ daycare procedures

What are OPD charges?

Covers the cost of doctor consultation and prescribed medical tests that may not require hospitalization.

Coverage status under National Mediclaim Policy?

Not covered under the plan.

What is COVID-19 Treatment?

COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. an approved center.

Coverage status under National Mediclaim Policy?

COVID-19 treatment cover is not available under this plan.

What is Cataract Treatment?

A common eye condition in which your vision gets blurred.

Coverage status under National Mediclaim Policy?

Under this plan, you are not covered for cataract treatment.

What is a No-Claim Bonus?

For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.

Coverage status under National Mediclaim Policy?

The plan offers a maximum of up to 50% of the sum insured.

What is Automatic Restoration?

Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.

Coverage status under National Mediclaim Policy?

The plan does not offer automatic restoration.

What is Daily Hospital Cash?

It is a cash amount that you receive each day during the time of hospitalization.

Coverage status under National Mediclaim Policy?

The daily hospital cash is unavailable under this policy but has a limit of room rent per day explained in the given table.

What is an Organ Donor Cover?

It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.

Coverage status under National Mediclaim Policy?

Under the plan, Organ Donor expenses are not covered.

What is a Maternity Cover?

It refers to the cover that includes expenses for normal and c-section procedures deliveries.

Coverage status under National Mediclaim Policy?

The maternity cover available under this plan is not covered.

What is a New Born Baby Cover?

It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the newborn cover are listed below and these common treatments can vary from plan to plan:

  • Congenital anomaly (conditions since birth)
  • Acute condition
  • Chronic condition
  • Premature delivery
  • Birth asphyxia
  • Day care treatment

Coverage status under National Mediclaim Policy?

Not covered under this plan

What is AYUSH Treatment?

Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.

Coverage status under National Mediclaim Policy?

AYUSH treatment is covered under this plan up to SI

What is IVF Treatment?

In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:

  • Full infertility
  • No fertility
  • Infertility diagnosis
  • Infertility diagnosis and limited fertility treatment
  • Medication (which may or may not include fertility drug prescriptions)

Coverage status under National Mediclaim Policy?

Not available

What is a Modern Treatment?

Medical treatments that demand modern technology such as robotic surgeries, stem cell therapy, etc.

Coverage status under National Mediclaim Policy?

Modern Treatment is covered for up to 25% of SI.

What is an Ambulance Cover?

An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.

Coverage status under National Mediclaim Policy?

This plan covers ambulance charges up to INR 2000.

What is an Air Ambulance?

Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.

Coverage status under National Mediclaim Policy?

Not covered

What is Compassionate Travel?

Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.

Coverage status under National Mediclaim Policy?

Not available

What is Global Coverage?

Any kind of medical/health emergency when you are outside of India.

Coverage status under National Mediclaim Policy?

Not available

What is E-Consultation?

If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.

Coverage status under National Mediclaim Policy?

The plan does not cover the expenses for e-consultation.

What is a Health Checkup?

A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.

Coverage status under National Mediclaim Policy?

The plan offers a Health Check-up benefit for every 4 claim free years.

What is a Second Medical Opinion?

If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.

Coverage status under National Mediclaim Policy?

The plan does not cover expenses for Second Medical Opinion.

What is Vaccination cover?

Coverage against the expenses incurred on vaccinations is provided by the insurance companies.

Coverage status under National Mediclaim Policy?

The plan does not offer vaccination coverage.

What is Co-payment?

In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.

Status under National Mediclaim Policy?

If opted, the policyholder may choose either of the two copayment options- 20% Co-payment on each admissible claim, with a 15% discount on premium.

15% Co-payment on each admissible claim, with a 10% discount on premium.

What is the Sub limit?

Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder.

Status under National Mediclaim Policy?

No sub-limits are available

National Mediclaim Plus Policy Benefits

Tax Benefits

Get tax relief under section 80D

Discounts

Avail various discounts

Health Incentives

Get rewarded for your healthy lifestyle & avail regular health check ups

Tax Benefits

Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.

Discounts

Avail 10% discount on online purchase of National Mediclaim Policy

Health Incentives

The plan lets the policyholder earn up to 50% of their SI as Health Returns if they follow a healthy lifestyle and stay fit. Expenses of health check up shall be reimbursed.

National Mediclaim Plus Policy Exclusions

Expenses related to the surgical treatment of obesity

Cosmetic or plastic surgery

Expenses of hazardous or adventure sports injury treatment

Drug/Alcohol Abuse

IVF

Maternity cover

Dental Treatment

Explore National Health Insurance

Know more about National Health Insurance, its claim process, buying process, and contact details by clicking on the sections below:

Explore other National Health Plans

National Health offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.

If you are looking for a policy that covers you for In-patient treatment expenses and 140+ Day Care Procedures then this plan is the right choice.

Unique Features

  • Avail cover up to 50 lakhs
  • Critical Illness benefit
  • 5% Increase in SI

This plan suits you best if you are a newly married individual or have dependents like kids or elderly parents as this health plan covers all of them along with you.

Unique Features

  • 12 Modern treatments
  • Maternity cover
  • Lifelong renewability

An affordable health plan, that offers 140+ day care procedures and covers pre-existing conditions like diabetes and hypertension.

Unique Features

  • Infertility treatment cover
  • Vaccination for children
  • Cataract Treatment Covered

National Parivar Mediclaim Plus Policy

If you are looking for a healthcare policy providing a high sum assured and covers your family members under one cover this is the right policy for you.

Unique Features

  • Cover up to 50 Lakhs
  • 5% No claim discount
  • Critical Illness Benefit

Standard indemnity health insurance product, having Sum Insured up to 10 Lakhs available in both individuals and floater type.

Unique Features

  • Individual/Floater
  • Online purchase discount
  • EMI facility available

National Super Top Up Mediclaim Policy

This policy covers your family members and offers high coverage at affordable prices. The policy has unique features that address all health-related concerns.

Unique Features

  • Organ donation covered
  • Morbid obesity treatment covered
  • Portability allowed

Overseas Mediclaim Business and Holiday

This plan is essential for those who like to travel, a package policy that covers travel emergencies while traveling abroad.

Unique Features

  • Coverage for business travel
  • Coverage for education abroad
  • Medical evacuation available

Overseas Mediclaim Employment and Study Plan

A plan beneficial for students who are traveling abroad for education, it is designed to cover medical evacuation, illness, and more.

Unique Features

  • Medical Evacuation
  • 5k USD medical emergency cover
  • Mental illness cover

National Critical Illness Policy

A unique benefit policy that covers expenses in the event of the insured person being affected with any of the listed critical illnesses.

Unique Features

  • Cover up to 75 Lakhs
  • Covers pre-existing conditions
  • 37 critical illnesses covered

National Senior Citizen Mediclaim Policy

If you are looking to secure your parents future this policy is a good choice, providing medical coverage to senior citizens between the age group of 60 to 80 years

Unique Features

  • 5% increase in SI
  • 2 Plan options
  • Covers spouse

Vidyarthi Mediclaim Policy for Students

Mediclaim for Students is a unique policy designed to provide health and personal accident cover to students.

Unique Features

  • Covers parents and students
  • Eyesight correction
  • Genetic disorders covered

This policy focuses on protecting the policyholders against the treatment expenses resulting due to COVID-19 infection.

Unique Features

  • Covers spouse and dependants
  • 5% discount for healthcare workers
  • 10% discount on online purchases

Health Insurance Articles

National Mediclaim Policy: FAQ's

1. If I wish to buy this policy, do I need to undergo a pre-policy medical test?

Individuals aged 50 years & above have to undergo a medical check-up.

2. Does the National Mediclaim Policy offer a portability feature?

As per the IRDAI guidelines, portability is allowed to/from similar products.

3. Does National Insurance offer a discount for buying Mediclaim Policy online?

Yes, a 10% discount is available.

4. What are the co-payment options available with this plan?

The plan comes with two co-payment options. These options are:

  • 20% Co-payment on each admissible claim under the Policy, with a 15% discount in total premium.
  • 15% Co-payment on each admissible claim under the Policy, with a 10% discount in total premium.

5. Is it possible to cancel my policy after buying it?

Yes, the National Insurance Company allows policyholders to cancel this policy by giving 15 days written notice. However, in case of any such an event, the premium amount is refunded for the unexpired policy period as detailed below:

Period of riskRate of premium to be charged
Up to 1 month1/4 of the annual rate
Up to 3 months1/2 of the annual rate
Up to 6 months3/4 of the annual rate
Exceeding 6 monthsFull annual rate

6. What are the premium modes available in National Insurance Mediclaim policies?

The National Insurance Company allows the customers to pay their premiums in 2 modes that are:

Cash payment at the branch or Online Payment

For the online payment mode, the policyholder can pay using their Credit Card, Debit Card or Net banking service.

7. I want to check the status of my National Insurance Mediclaim policy? How can I do that?

To check the status of your National Insurance Mediclaim policy, you need to visit the official website of the company and login into the portal with your valid credentials.

8. Does the National Mediclaim policy offer any free-look period?

Yes, a health insurance plan purchased through National Insurance has a 15-day free look period during which the policyholder can return it without any penalties beig charged on him.

9. What reports are needed for the pre-policy check-up?

The following reports are necessary for the pre-policy checkup:

  • Physical examination (report must be signed by a doctor with at least an MD degre
  • HbA1c
  • Lipid profile
  • Serum creatinine
  • Urine routine and microscopic examination
  • ECG
  • Examination of the eyes (including retinoscopy)
  • Any other inquiry that the firm requires

The date of medical reports shall not be more than 30 (thirty) days before the proposal date.

10. Is the National Mediclaim Policy a good mediclaim policy?

National Mediclaim Policy is a good and affordable mediclaim policy which covers you and your family members in case of any medical emergency.

11. What is the entry age for National Mediclaim Policy?

Any individual can be covered who is above 18 years of age under this policy. Children aged between 3 months to 18 years can also be included if at least one of the parents is covered under the same policy.

12. What is the maximum entry age for this policy?

The maximum entry age for National Mediclaim Policy is 65 years.

13. Can a spouse be covered under this policy?

Yes. Self, spouse, dependent children and dependent parents can be covered under this policy.

14. What is the age limit for policy renewal?

Lifelong policy renewal feature is available for National Mediclaim Policy.

15. Is treatment for obesity covered under National Mediclaim Policy?

No, this policy does not cover obesity treatments.

16. Is maternity cover available under National Mediclaim Policy?

No, maternity cover is not available.

Read Reviews & Ratings

Customer Review Image

simaranjeet kaur

Jalandhar

March 14, 2022

My father in law lives alone in jalandhar and we wanted an insurance company that take cares of him in our absence. They are very good with their commitment and service.

Customer Review Image

Urmil Thakur

Kochi

September 1, 2021

I bought my health plan from National a while back. Recently had to make a claim for hospitalization. I was a little worried but the response time was at best amazing! Thanks guys

Customer Review Image

Akshay Malhotra

Gurgaon

August 18, 2021

I have bought health insurance from National Health Insurance and I am very impressed by their services and attention towards customers.

Customer Review Image

Pooja Singh

Delhi

May 10, 2021

I will recommend everyone to buy health insurance plan from this company because I am very happy with the plan I purchased from the company. I am using my insurance from two years and till now ...

Customer Review Image

Bipinchandra Somabhai Patel

Vadodara

October 26, 2020

I want to portability of United India insurance company individual health mediclaim policy taken since December 2005 and falling due for renewal on 06-12-2020

Customer Review Image

Shilpa

Thane

May 6, 2018

I hold a National Parivar Mediclaim insurance plan with National Insurance from last 3 years, i am happy with the coverage value of this policy.

Customer Review Image

alok kumar de

Kolkata

October 16, 2017

my varistha mediclaim policy number of which is-150100501610012195 renewed this year but when i want to know my claim claim status online it says wrong policy number then what is the corect num...

Customer Review Image

Sabhadiya nareshbhai govindbhai

Surat

September 30, 2017

My father has been admitted in hospital but ypur company not receive my call I inform you for admitted my father date 30/09/2017

View All National Health Insurance Reviews